Provider Demographics
NPI:1659502573
Name:HOWARD, KIMBERLY LYNN (PA-C)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:LYNN
Last Name:HOWARD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 W MAIN ST
Mailing Address - Street 2:#202
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-3663
Mailing Address - Country:US
Mailing Address - Phone:503-740-3880
Mailing Address - Fax:
Practice Address - Street 1:CR 2 BLDG WHITE ZONE ROOM 3589
Practice Address - Street 2:DUKE UNIVERSITY/S HOSPITAL/SURGERY
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-0001
Practice Address - Country:US
Practice Address - Phone:919-684-4891
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-28
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC001001960363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant